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Background The aim of this study is to assess the clinical effectiveness of the 3-step hand hygiene (HH) technique (3-HT) compared with the 6-step HH technique (6-HT; World Health Organization 6-step technique) using an alcohol-based hand rub. Methods A randomized controlled crossover trial was conducted from November to December 2023 in 10 wards of a tertiary A-level hospital according to CONSORT guidelines. The 240 healthcare workers (HCWs) were randomly divided into the 3-HT intervention group or the 6-HT control group. The trial was conducted in 2 stages, and the effectiveness of each indicator in the 2 groups was compared after a washout period of 2 weeks. Results Compared with the 6-HT, the 3-HT has demonstrated significant superiority in all indicators of HH compliance as well as the accuracy rate of HH practices. The total HH median times for the 3-HT and 6-HT were 16.00 (interquartile range, 15.00–20.00) and 32.50 (30.00–40.00) seconds, respectively (P <.05). The reduction factors for bacterial colony-forming unit counts did not differ and the colony-forming unit counts were not significantly different. Bacillus , Staphylococcus , and Micrococcus were detected before and after the use of hand rubs. HCWs preferred the 3-HT over the 6-HT. There were no significant difference in healthcare-associated infections rate between the 2 techniques. Conclusions The 3-HT was significantly superior to the 6-HT in terms of the HH eligibility rate, compliance, and HH time. The safety and feasibility of the 3-HT were verified by assessing microorganism count. [ABSTRACT FROM AUTHOR]

Abstract Background Transcutaneous electrical nerve stimulation (TENS) is a non-invasive modality that utilizes electrical currents to modulate pain in populations with acute and chronic pain. TENS has been demonstrated to produce hypoalgesic effects in postoperative pain, fibromyalgia, knee osteoarthritis, and healthy subjects. Transcutaneous auricular vagus nerve stimulation (TaVNS) is a non-invasive modality that modulates the vagus nerve by stimulating its auricular branches. The effects of the combination of TENS and TaVNS on producing an analgesic response have not been studied. Considering that TENS and TaVNS both stimulate similar analgesic pathways but through different means of activation, we can hypothesize that a combination of both methods can produce a more pronounced analgesic response. Therefore, the objective of this study is to assess the hypoalgesic effect of a combination of TENS and TaVNS in pain-free subjects. Methods/design The study will be a simple crossover design conducted at the University of Hartford. Subjects will be recruited from the University of Hartford population via oral communication, digital flyers, and posters on campus. Thirty participants will undergo two sessions in a crossover manner with one week in between. During one session, the participants will receive TENS with active TaVNS and the other session will be a placebo procedure (TENS with placebo TaVNS). The order of these sessions will be randomized. Importantly, the pressure pain threshold (PPT) and heat pain threshold (HPT) assessors will be blinded to the treatment category. For active TaVNS, a frequency of 25 Hz will be applied with a pulse duration of 200 µs. For placebo TaVNS, the intensity will be increased to a sensory level and then decreased to 0 mA. High-frequency TENS of 100 Hz will be applied in both sessions, with a pulse duration of 200 µsec, asymmetrical biphasic square waveform, and intensity of maximal tolerance without pain. TENS and TaVNS will be turned on for 30 min after a baseline measurement of outcomes. TENS and TaVNS will then be turned off, but the electrodes will remain on until completion of post-treatment assessment. Pressure pain threshold, heat pain threshold, blood pressure, oxygen saturation, and heart rate will be tested 4 times: Once pre-intervention, once during intervention, once immediately after the intervention, and once 15 min post-intervention. Statistical analysis of the data obtained will consider a significance level of p

Background: Transcutaneous electrical nerve stimulation (TENS) is a non-invasive modality that utilizes electrical currents to modulate pain in populations with acute and chronic pain. TENS has been demonstrated to produce hypoalgesic effects in postoperative pain, fibromyalgia, knee osteoarthritis, and healthy subjects. Transcutaneous auricular vagus nerve stimulation (TaVNS) is a non-invasive modality that modulates the vagus nerve by stimulating its auricular branches. The effects of the combination of TENS and TaVNS on producing an analgesic response have not been studied. Considering that TENS and TaVNS both stimulate similar analgesic pathways but through different means of activation, we can hypothesize that a combination of both methods can produce a more pronounced analgesic response. Therefore, the objective of this study is to assess the hypoalgesic effect of a combination of TENS and TaVNS in pain-free subjects. Methods/design: The study will be a simple crossover design conducted at the University of Hartford. Subjects will be recruited from the University of Hartford population via oral communication, digital flyers, and posters on campus. Thirty participants will undergo two sessions in a crossover manner with one week in between. During one session, the participants will receive TENS with active TaVNS and the other session will be a placebo procedure (TENS with placebo TaVNS). The order of these sessions will be randomized. Importantly, the pressure pain threshold (PPT) and heat pain threshold (HPT) assessors will be blinded to the treatment category. For active TaVNS, a frequency of 25 Hz will be applied with a pulse duration of 200 µs. For placebo TaVNS, the intensity will be increased to a sensory level and then decreased to 0 mA. High-frequency TENS of 100 Hz will be applied in both sessions, with a pulse duration of 200 µsec, asymmetrical biphasic square waveform, and intensity of maximal tolerance without pain. TENS and TaVNS will be turned on for 30 min after a baseline measurement of outcomes. TENS and TaVNS will then be turned off, but the electrodes will remain on until completion of post-treatment assessment. Pressure pain threshold, heat pain threshold, blood pressure, oxygen saturation, and heart rate will be tested 4 times: Once pre-intervention, once during intervention, once immediately after the intervention, and once 15 min post-intervention. Statistical analysis of the data obtained will consider a significance level of p < 0.05. Discussion: This study will provide evidence concerning the combined effects of TENS and TaVNS on pain threshold in pain-free participants. Based on the outcomes, a greater understanding of how TENS and TaVNS, when used in conjunction, can modulate pain pathways. Trial registration: ClinicalTrials.gov NCT06361381. Registered on 09 April 2024. [ABSTRACT FROM AUTHOR]

Background: Postural orthostatic tachycardia syndrome (POTS) is a complex, multifaceted disorder that impairs functional status and quality of life. Current pharmacological treatments are limited.Objectives: This study investigated the effect of ivabradine (selective blocker of the Ifunny channel in the sinoatrial node) on heart rate, quality of life (QOL), and plasma norepinephrine (NE) levels in patients with hyperadrenergic POTS defined by plasma NE >600 pg/ml and abnormal tilt table test.Methods: In total, 22 patients with hyperadrenergic POTS as the predominant subtype completed a randomized, double-blinded, placebo-controlled, crossover trial with ivabradine. Patients were randomized to start either ivabradine or placebo for 1 month, and then were crossed over to the other treatment for 1 month. Heart rate, QOL, and plasma NE levels were measured at baseline and at the end of each treatment month.Results: The average age was 33.9 ± 11.7 years, 95.5% were women (n = 21), and 86.4% were White (n = 23). There was a significant reduction in heart rate between placebo and ivabradine (p < 0.001). Patients reported significant improvements in QOL with RAND 36-Item Health Survey 1.0 for physical functioning (p = 0.008) and social functioning (p = 0.021). There was a strong trend in reduction of NE levels upon standing with ivabradine (p = 0.056). Patients did not experience any significant side-effects, such as bradycardia or hypotension, with ivabradine.Conclusion: Ivabradine is safe and effective in significantly improving heart rate and QOL in patients with hyperadrenergic POTS as the predominant subtype. [ABSTRACT FROM AUTHOR]

Feldenkrais ‘Functional Integration’ (FI) is a widely used type of body work with a focus on the continuous integration of body sensations and awareness with movement. The method is, amongst others, known for improving balance in aging populations, but also for its ability to relax muscles. With participants treated in the supine position FI is potentially changing the surface area of the body in contact with the surface on which a participant is lying. So far, no prior study has assessed this claim. We evaluated objectively and subjectively if a treatment with FI would induce changes in pressure and contact surface of the body on the mat. Thirty volunteers received an individual treatment with FI, in a randomized order on both sides of the body. Pressure and contact surface was documented with the Xsensor-Measurement-System. Subjective sensations were assessed with a self-report scale. Due to two parallel assessments alpha-level was adjusted to α = 0.025. We found that pressure and contact surface of the body on the mat significantly changed after the treatment (factor time: p < 0.0001, ηp2 = 0.90). We also found that pressure and contact surface increased significantly on the left side for the group that started with the left side first (time × group p = 0.016; ηp2 = 0.62), but less so on the right side for the group that started with the right side first (time × group: p = 0.056) although there was still a substantial effect size (ηp2 = 0.54). The subjective reports confirmed the physical measurements. In conclusion our results demonstrate for the first time that the treatment with the Feldenkrais method changes muscle tone leading to a more relaxed supine position with respect to pressure and contact surface on the mat.

Feldenkrais 'Functional Integration' (FI) is a widely used type of body work with a focus on the continuous integration of body sensations and awareness with movement. The method is, amongst others, known for improving balance in aging populations, but also for its ability to relax muscles. With participants treated in the supine position FI is potentially changing the surface area of the body in contact with the surface on which a participant is lying. So far, no prior study has assessed this claim. We evaluated objectively and subjectively if a treatment with FI would induce changes in pressure and contact surface of the body on the mat. Thirty volunteers received an individual treatment with FI, in a randomized order on both sides of the body. Pressure and contact surface was documented with the Xsensor-Measurement-System. Subjective sensations were assessed with a self-report scale. Due to two parallel assessments alpha-level was adjusted to α = 0.025. We found that pressure and contact surface of the body on the mat significantly changed after the treatment (factor time: p < 0.0001, η p 2 = 0.90). We also found that pressure and contact surface increased significantly on the left side for the group that started with the left side first (time × group p = 0.016; η p 2 = 0.62), but less so on the right side for the group that started with the right side first (time × group: p = 0.056) although there was still a substantial effect size ( η p 2 = 0.54). The subjective reports confirmed the physical measurements. In conclusion our results demonstrate for the first time that the treatment with the Feldenkrais method changes muscle tone leading to a more relaxed supine position with respect to pressure and contact surface on the mat. [ABSTRACT FROM AUTHOR]

Introduction: Compared to standard hemodialysis (S-HD), postdilution hemodiafiltration (HDF) has been associated with improved survival., Methods: To assess whether intradialytic hemodynamics may play a role in this respect, 40 chronic dialysis patients were cross-over randomized to S-HD (dialysate temperature [Td] 36.5 °C), cooled HD (C-HD; Td 35.5 °C), and HDF (low-volume [LV-HDF)] and high-volume [HV-HDF], both Td 36.5 °C, convection volume 15 liters, and at least 23 liters per session, respectively), each for 2 weeks. Blood pressure (BP) was measured every 15 minutes. The primary endpoint was the number of intradialytic hypotensive (IDH) episodes per session. IDH was defined as systolic BP (SBP) less than 90 mmHg for predialysis SBP less than 160 mmHg and less than 100 mmHg for predialysis SBP greater than or equal to 160 mmHg, independent of symptoms and interventions. A post hoc analysis on early-onset IDH was performed as well. Secondary endpoints included intradialytic courses of SBP, diastolic BP (DBP) and mean arterial pressure (MAP)., Results: During S-HD, IDH occurred 0.68 episodes per session, which was 3.2 and 2.5 times higher than during C-HD (0.21 per session, P  < 0.0005) and HV-HDF (0.27 per session, P  < 0.0005), respectively. Whereas the latter 2 strategies showed similar frequencies, HV-HDF differed significantly from LV-HDF ( P  = 0.02). A comparable trend was observed for early-onset IDH: S-HD (0.32 per session), C-HD (0.07 per session, P  < 0.0005) and HV-HDF (0.10 per session, P  = 0.001). SBP, DBP, and MAP declined during S-HD (-6.8, -5.2, -5.2 mmHg per session; P  = 0.004, P  < 0.0005, P  = 0.002 respectively), which was markedly different from C-HD ( P  < 0.01)., Conclusion: Though C-HD and HV-HDF showed the lowest IDH frequency and the best intradialytic hemodynamic stability, all parameters were most disrupted in S-HD. Therefore, the survival benefit of HV-HDF over S-HD may be partly caused by a more beneficial intradialytic BP profile., (© 2022 International Society of Nephrology. Published by Elsevier Inc.)